Career Summary

Biography

The combination of an industrial science/engineering background and research higher degree studies within health science (medicine) has provided me with a good understanding into the practical applications and importance of investigation and objective testing for evidence based medicine. My current position is as an NHMRC Early Career Research Fellow in the Clinical Toxicology Research Group within the School of Medicine and Public Health. I co-ordinate and conduct randomised controlled trials into snake and spider envenoming as well as observational studies into the epidemiology and characterisation of medication toxicity. I am particularly interested in neuropathic disorders and neuropathic medication profiling.

My previous research role was based in Respiratory Medicine investigating the causes and mechanisms involved in refractory chronic cough. I developed objective cough testing at the HMRI research facility and in the department of respiratory medicine at John Hunter Hospital. I like to approach my research from a clinical perspective when feasible by being actively involved in the testing and collection of data from research participants. Analysing the subsequent data is always interesting and the translation of findings into practical application.

Research ExpertiseI have recently (early 2014) had a change in my research focus by commencing a post-doctoral research fellow position with the Clinical Toxicology Research Group located at the Calvary Mater Newcastle hospital site. Here I continue to develop my interest in the assessment of the efficacy and safety of drug therapy. During my PhD I completed a randomised controlled trial looking at the effectiveness and adverse effects of gabapentin medication in the treatment of chronic cough. The snake and spider studies that I now investigate have provided me with the opportunity to conduct three more RCTs testing the effects of medications. My prior research focus was in the identification and treatment of patients with refractory and idiopathic chronic cough. Ten years of research in this area led to the significant finding that laryngeal hypersensitivity is common in refractory chronic cough patients and that this can be successfully treated with neuropathic medications such as gabapentin or by behavioural techniques such as speech pathology and cough suppression techniques.

Teaching ExpertiseCurrent co-supervisor of two PhD students. One of which is investigating myotoxicity and the early use of antivenom in Australia and Sri Lanka while my second student's PhD focuses on antidotes.Brief teaching role at Newcastle TAFE to 3rd and 4th year Applied Science (Chemistry) students before my move into medical research.

Background: Asthma is a heterogeneous inflammatory disease and eosinophilic, noneosinophilic and neutrophilic forms are recognised. While clinically similar to eosinophilic asthma... [more]

Background: Asthma is a heterogeneous inflammatory disease and eosinophilic, noneosinophilic and neutrophilic forms are recognised. While clinically similar to eosinophilic asthma, patients with non-eosinophilic asthma have different responses to treatment and little is known about the triggers of symptoms and inflammation. Objective: This study sought to characterise asthma control, exacerbation frequency and potential triggers of non-eosinophilic and specifically neutrophilic asthma such as infection, gastroesophageal reflux disease, and rhinosinusitis. Methods: Adults with asthma (n=65; doctor's diagnosis plus demonstrated response to bronchodilator and/or airways hyperresponsiveness to hypertonic saline) were recruited from the Respiratory and Sleep Medicine Ambulatory Care Service at John Hunter Hospital, NSW, Australia. Questionnaires were administered to assess gastroesophageal reflux disease, rhinosinusitis and asthma control. A sputum induction was performed and sputum was processed for assessment of inflammatory cells, infection, and lipid laden macrophages (Oil Red O). Results: Participants with neutrophilic asthma (n=11, 23%) had a higher frequency of primary care doctor visits for asthma exacerbations and a high prevalence (>70%) of chest infections in the previous 12 months. There was also an increased prevalence of rhinosinusitis (64%) and increased symptoms of gastroesophageal reflux disease compared to those with eosinophilic asthma. Conclusions: The clinical pattern of neutrophilic asthma is different from paucigranulocytic and eosinophilic asthma with evidence of abnormal upper airways responses. Specific and targeted treatment of these airway problems may assist in the control and management of neutrophilic asthma.

Research Supervision

Current Supervision

Commenced

Research Title / Program / Supervisor Type

2015

Antidotes and Treatments in Overdose&lt;p&gt;&lt;span lang="EN-US" style="color:black;"&gt;The research proposal aims to study the antidotes and treatments that clinical toxicologists commonly recommend in the management of drug toxicity as well as those used less frequently in rare but very toxic overdoses. &lt;span&gt;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;Pharmacology, The University of NewcastleCo-Supervisor

2015

Snake Envenoming in Australia and Beyond: Investigating Myotoxicity and the Early use of AntivenomPharmacology, Faculty of Health and MedicineCo-Supervisor

2015

Snake Envenoming in Australia and Beyond: Investigating Myotoxicity and the Early use of AntivenomPharmacology, Clinical Toxicology Research GroupCo-Supervisor

2015

Antidotes and Treatments in OverdosePharmacology, Faculty of Health and MedicineCo-Supervisor

2015

Antidotes and Treatments in OverdosePharmacology, Clinical Toxicology Research GroupCo-Supervisor

Research Projects

<span style="font-size:11.0pt;line-height:115%;font-family:'Calibri',sans-serif;color:black;">The purpose of this project is to investigate the effectiveness and safety of early antivenom administration for the treatment of red-bellied black snake bites/envenoming. Red-bellied black snakebites are the most common in Eastern Australia and are not routinely treated with antivenom because they appear to cause minor effects and there is concern about the risk of allergic reactions to antivenom. However, recent work by the ASP investigators suggests that the early use of antivenom will reduce the chance of people developing muscle damage. This study is a randomised controlled trial of one vial of tiger snake antivenom compared to standard care (placebo) and this will provide good evidence for or against the early administration of antivenom for muscle damage. The study will also investigate whether antivenom neutralises other effects of RBBS envenoming and determine the frequency of allergic reactions, including anaphylaxis, after antivenom use.</span>

Randomised controlled trial of early antivenom administration in Australian snakebite 2015 -

<p>Current standard practice for any snake bite requires laboratory testing to determine if a patient has been envenomed, and coagulation studies are the most important tests. The administration of antivenom is then based on the presence of clinical effects of envenoming and abnormal laboratory investigations. Many of these envenoming effects are irreversible, so once they develop they are unlikely to be reversed by antivenom. This means that, antivenom needs to be given prior to the development of irreversible envenoming syndromes. The aim of this project will be to administer antivenom early &ndash; as soon as the patient presents to hospital â without first waiting for laboratory tests or the development of clinical signs of envenoming (except nonâspecific symptoms), and/or retrieval to a major hospital for laboratory testing. The objective is to determine if the administration of early antivenom will prevent envenoming effects and therefore significant morbidity or death.</p>